Provider Demographics
NPI:1518094630
Name:PAMELA L MEYER D.O. PC
Entity Type:Organization
Organization Name:PAMELA L MEYER D.O. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:484-851-3000
Mailing Address - Street 1:32 KICHLINE AVE
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-1010
Mailing Address - Country:US
Mailing Address - Phone:484-851-3000
Mailing Address - Fax:484-851-3604
Practice Address - Street 1:32 KICHLINE AVE
Practice Address - Street 2:
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055-1010
Practice Address - Country:US
Practice Address - Phone:484-851-3000
Practice Address - Fax:484-851-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008600L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG17799Medicare UPIN